The use of suture anchors in reconstruction of sacral pressure ulcers with gluteal fasciocutaneous advancement flaps.

Suture anchors have already been successfully used for soft-tissue fixation to bone. In this study, suture anchors were used in sacral pressure ulcer reconstruction, aiming at secure midline attachment of gluteal fasciocutaneous flaps, obliteration of any dead space, and recreation of the natal cleft. Thirteen patients with sacral pressure ulcers were treated with bilateral gluteal fasciocutaneous V-Y advancement flaps. Suture anchors were used to invert and attach the flaps to the midline crest of the sacrum. All flaps healed well, no postoperative anchor failure or wound dehiscence was noticed, and the esthetic result was very pleasing. In conclusion, the use of suture anchors offers an easy, practical, and secure attachment of V-Y advancement gluteal fasciocutaneous flaps in sacral pressure ulcer reconstruction. Main advantages of the method suggested are reduction of suture-line tension, obliteration of any cavity at the midline, and recreation of the natal cleft.